Gioia Di Credico1, Valeria Edefonti2, Jerry Polesel3, Francesco Pauli4, Nicola Torelli4, Diego Serraino3, Eva Negri5, Daniele Luce6, Isabelle Stucker7, Keitaro Matsuo8, Paul Brennan9, Marta Vilensky10, Leticia Fernandez11, Maria Paula Curado12, Ana Menezes13, Alexander W Daudt14, Rosalina Koifman15, Victor Wunsch-Filho16, Ivana Holcatova17, Wolfgang Ahrens18, Pagona Lagiou19, Lorenzo Simonato20, Lorenzo Richiardi21, Claire Healy22, Kristina Kjaerheim23, David I Conway24, Tatiana V Macfarlane25, Peter Thomson26, Antonio Agudo27, Ariana Znaor9, Leonardo F Boaventura Rios28, Tatiana N Toporcov16, Silvia Franceschi3, Rolando Herrero9, Joshua Muscat29, Andrew F Olshan30, Jose P Zevallos31, Carlo La Vecchia32, Deborah M Winn33, Erich M Sturgis34, Guojun Li34, Eleonora Fabianova35, Jolanda Lissowska36, Dana Mates37, Peter Rudnai38, Oxana Shangina39, Beata Swiatkowska40, Kirsten Moysich41, Zuo-Feng Zhang42, Hal Morgenstern43, Fabio Levi44, Elaine Smith45, Philip Lazarus46, Cristina Bosetti47, Werner Garavello48, Karl Kelsey49, Michael McClean50, Heribert Ramroth51, Chu Chen52, Stephen M Schwartz52, Thomas L Vaughan52, Tongzhang Zheng53, Gwenn Menvielle54, Stefania Boccia55, Gabriella Cadoni56, Richard B Hayes57, Mark Purdue33, Maura Gillison58, Stimson Schantz59, Guo-Pei Yu60, Hermann Brenner61, Gypsyamber D'Souza62, Neil D Gross63, Shu-Chun Chuang64, Paolo Boffetta65, Mia Hashibe66, Yuan-Chin Amy Lee67, Luigino Dal Maso3. 1. Department of Statistics, Padua University, Padua, Italy; Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy. 2. Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy. Electronic address: valeria.edefonti@unimi.it. 3. Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy. 4. Department of Economics, Business, Mathematics and Statistics, University of Trieste, Trieste, Italy. 5. Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milano, Italy. 6. Université de Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, Pointe-à-Pitre, France. 7. Inserm, Center for Research in Epidemiology and Population Health (CESP), Cancer and Environment team, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. 8. Aichi Cancer Center Research Institute, Nagoya, Japan. 9. International Agency for Research on Cancer, Lyon, France. 10. Institute of Oncology Angel H. Roffo, University of Buenos Aires, Argentina. 11. Institute of Oncology and Radiobiology, Havana, Cuba. 12. Epidemiology, CIPE/ACCAMARGO, Sao Paulo, Brazil. 13. Universidade Federal de Pelotas, Pelotas, Brazil. 14. Hospital Moinhos de Vento, Porto Alegre, Brazil. 15. Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil. 16. University of São Paulo School of Public Health, São Paulo, Brazil. 17. Institute of Hygiene & Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic. 18. Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany; University of Bremen, Faculty of Mathematics and Computer Science, Bremen, Germany. 19. Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. 20. Department of Cardiovascular and Thoracic Sciences and Public Health, University of Padova, Padova, Italy. 21. Department of Medical Sciences, University of Turin, Turin, Italy. 22. Trinity College School of Dental Science, Dublin, Ireland. 23. Cancer Registry of Norway, Oslo, Norway. 24. School of Medicine, Dentistry, and Nursing, University of Glasgow, Glasgow, UK. 25. School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK and School of Medicine, University of Dundee, Dundee, UK. 26. University of Hong Kong, Hong Kong, China. 27. Institut Catala Oncologia, Barcelona, Spain. 28. University of São Paulo School of Medicine, São Paulo, Brazil. 29. Penn State College of Medicine, Hershey, PA, USA. 30. University of North Carolina School of Public Health, Chapel Hill, NC, USA. 31. Division of Head and Neck Surgical Oncology in the Department of Otolaryngology/Head and Neck Surgery at Washington University School of Medicine, USA. 32. Branch of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro", Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy. 33. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. 34. UT - M.D. Anderson Cancer Center, Houston, TX, USA. 35. Regional Authority of Public Health in Banska Bystrica, Slovakia. 36. The M. Skasodowska-Curie Memorial Cancer Center and Institute of Oncology, Dept. of Cancer Epidemiology and Prevention, Warsaw, Poland. 37. National Institute of Public Health, Bucharest, Romania. 38. National Institute of Environmental Health to National Public Health Institute, Budapest, Hungary. 39. Cancer Research Centre, Moscow, Russia. 40. Institute of Occupational Medicine, Lodz, Poland. 41. Roswell Park Cancer Institute, Buffalo, NY, USA. 42. UCLA School of Public Health, Los Angeles, CA, USA. 43. Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Department of Urology, Medical School, University of Michigan, Ann Arbor, MI, USA. 44. Institut Universitaire de Medecine Sociale et Preventive (IUMSP), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland. 45. College of Public Health, University of Iowa, Iowa City, IA, USA. 46. Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA. 47. Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy. 48. Department of Otorhinolaryngology, School of Medicine and Surgery, University of Milano, Bicocca, Monza, Italy. 49. Brown University, Providence, RI, USA. 50. Boston University School of Public Health, Boston, MA, USA. 51. University of Heidelberg, Germany. 52. Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 53. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA. 54. Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Department of Social Epidemiology, F75012 Paris, France. 55. Department of Woman and Child Health and Public Health, Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Sezione di Igiene, Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italy. 56. Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Istituto di Clinica Otorinolaringoiatrica, Università Cattolica del Sacro Cuore, Roma, Italy. 57. Division of Epidemiology, New York University School Of Medicine, New York, NY, USA. 58. "Thoracic/Head and Neck Medical Oncology", The University of Texas MD Anderson Cancer Center, TX, USA. 59. New York Eye and Ear Infirmary, New York, NY, USA. 60. Medical Informatics Center, Peking University, China. 61. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany. 62. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 63. Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 64. Institute of Population Health Sciences, National Health Research Institutes, Taiwan. 65. The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 66. Division of Public Health, Department of Family & Preventive Medicine and Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA. 67. Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
Abstract
OBJECTIVES: This study aimed at re-evaluating the strength and shape of the dose-response relationship between the combined (or joint) effect of intensity and duration of cigarette smoking and the risk of head and neck cancer (HNC). We explored this issue considering bivariate spline models, where smoking intensity and duration were treated as interacting continuous exposures. MATERIALS AND METHODS: We pooled individual-level data from 33 case-control studies (18,260 HNC cases and 29,844 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. In bivariate regression spline models, exposures to cigarette smoking intensity and duration (compared with never smokers) were modeled as a linear piecewise function within a logistic regression also including potential confounders. We jointly estimated the optimal knot locations and regression parameters within the Bayesian framework. RESULTS: For oral-cavity/pharyngeal (OCP) cancers, an odds ratio (OR) >5 was reached after 30 years in current smokers of ∼20 or more cigarettes/day. Patterns of OCP cancer risk in current smokers differed across strata of alcohol intensity. For laryngeal cancer, ORs >20 were found for current smokers of ≥20 cigarettes/day for ≥30 years. In former smokers who quit ≥10 years ago, the ORs were approximately halved for OCP cancers, and ∼1/3 for laryngeal cancer, as compared to the same levels of intensity and duration in current smokers. CONCLUSION: Referring to bivariate spline models, this study better quantified the joint effect of intensity and duration of cigarette smoking on HNC risk, further stressing the need of smoking cessation policies.
OBJECTIVES: This study aimed at re-evaluating the strength and shape of the dose-response relationship between the combined (or joint) effect of intensity and duration of cigarette smoking and the risk of head and neck cancer (HNC). We explored this issue considering bivariate spline models, where smoking intensity and duration were treated as interacting continuous exposures. MATERIALS AND METHODS: We pooled individual-level data from 33 case-control studies (18,260 HNC cases and 29,844 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. In bivariate regression spline models, exposures to cigarette smoking intensity and duration (compared with never smokers) were modeled as a linear piecewise function within a logistic regression also including potential confounders. We jointly estimated the optimal knot locations and regression parameters within the Bayesian framework. RESULTS: For oral-cavity/pharyngeal (OCP) cancers, an odds ratio (OR) >5 was reached after 30 years in current smokers of ∼20 or more cigarettes/day. Patterns of OCP cancer risk in current smokers differed across strata of alcohol intensity. For laryngeal cancer, ORs >20 were found for current smokers of ≥20 cigarettes/day for ≥30 years. In former smokers who quit ≥10 years ago, the ORs were approximately halved for OCP cancers, and ∼1/3 for laryngeal cancer, as compared to the same levels of intensity and duration in current smokers. CONCLUSION: Referring to bivariate spline models, this study better quantified the joint effect of intensity and duration of cigarette smoking on HNC risk, further stressing the need of smoking cessation policies.
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Authors: Gioia Di Credico; Jerry Polesel; Luigino Dal Maso; Francesco Pauli; Nicola Torelli; Daniele Luce; Loredana Radoï; Keitaro Matsuo; Diego Serraino; Paul Brennan; Ivana Holcatova; Wolfgang Ahrens; Pagona Lagiou; Cristina Canova; Lorenzo Richiardi; Claire M Healy; Kristina Kjaerheim; David I Conway; Gary J Macfarlane; Peter Thomson; Antonio Agudo; Ariana Znaor; Silvia Franceschi; Rolando Herrero; Tatiana N Toporcov; Raquel A Moyses; Joshua Muscat; Eva Negri; Marta Vilensky; Leticia Fernandez; Maria Paula Curado; Ana Menezes; Alexander W Daudt; Rosalina Koifman; Victor Wunsch-Filho; Andrew F Olshan; Jose P Zevallos; Erich M Sturgis; Guojun Li; Fabio Levi; Zuo-Feng Zhang; Hal Morgenstern; Elaine Smith; Philip Lazarus; Carlo La Vecchia; Werner Garavello; Chu Chen; Stephen M Schwartz; Tongzhang Zheng; Thomas L Vaughan; Karl Kelsey; Michael McClean; Simone Benhamou; Richard B Hayes; Mark P Purdue; Maura Gillison; Stimson Schantz; Guo-Pei Yu; Shu-Chun Chuang; Paolo Boffetta; Mia Hashibe; Amy Lee Yuan-Chin; Valeria Edefonti Journal: Br J Cancer Date: 2020-08-24 Impact factor: 7.640